Healthcare Provider Details

I. General information

NPI: 1477017366
Provider Name (Legal Business Name): LEONTYNE GULLEY WILLIAMS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15912 SYLVAN LOOP RD
FOSTERS AL
35463-9631
US

IV. Provider business mailing address

566 BLACKBERRY GLN
SPRINGVILLE AL
35146-4255
US

V. Phone/Fax

Practice location:
  • Phone: 205-587-7040
  • Fax:
Mailing address:
  • Phone: 205-587-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberL757
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number204031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: